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Phyto-Riker, a US investor-led, start-up pharmaceutical company in Ghana, contemplates the effects of needs generated by the HIV epidemic in sub-Saharan Africa on its future business plans. In April 2001, it appeared as if political will was crystallizing around the world for the devotion of substantial resources to fight the epidemic. It was not certain what amount of resources would be available or how the resources would be expended. In the meantime, public health officials, AIDS activists, philanthropists, and pharmaceutical companies were engaged in various activities designed to address the HIV problem from their own points of view. This case gives students the opportunity to explore decision making when operating in third-world environments where uncertainty can be prevalent. Students can also wrestle with the economics and regulation of the pharmaceuticals industry and the ethics of drug pricing.